Page 61 - Simplicity is Key in CRT

Table 2. Demographic data, baseline clinical parameters of the 316 CRT patients included in the study.
Parameter
All patients (n=316)
Male gender, n (%)
230 (73)
Age, years, median [IQR]
71 [62-77]
Ischemic aetiology, n (%)
196 (62)
Persistent atrial fibrillation, n (%)
56 (16)
NYHA functional class II/III-IV, n (%)
129 (41) /164 (52)
ECG parameters
Heart rate, bpm, median [IQR],
71 [62-83]
QRS duration, ms, median, [IQR]
156 [140-170]
QRS ≥ 150ms, n (%)
198 (63)
LBBB + by ESC criteria 2006, n (%)
106 (33)
LBBB + by ESC criteria 2009, n (%)
145 (46)
LBBB + by ESC criteria 2013, n (%)
148 (47)
LBBB + by AHA/ACC/HRS, n (%)
92 (29)
LBBB + by Strauss et al. , n (%)
194 (61)
Medication, n (%)
Beta-blocker
297 (94)
ACE inhibitor or ARB
278 (88)
MRAs
230 (73)
Diuretics
230 (73)
Amiodarone
38 (12)
Echocardiographic parameters, median [IQR]
LV ejection fraction, %
28 [23-33]
LV end-diastolic volume, ml
184 [147-227]
LV end-systolic volume, ml
133 [101-172]
NYHA = New York Heart Association, LBBB+ = Left bundle branch block positive according to the indicated classification, ACE = Angiotensin- converting-enzyme, MRAs = mineralocorticoid receptor antagonists, ARB = Angiotensin receptor blocker; LV = Left Ventricle.
The frequency of LBBB strongly depended on the definition used, the proportion of patients meeting LBBB criteria ranged from 29% (AHA) to 61% (Strauss). One-hundred ninety-eight patients (63%) had a LBBB according to at least one definition; of these, of which 33% was positive for all five ECG classifications. As illustrated in Supplemental Table 1, overlap among the LBBB definitions is present.
QRS morphology and reverse remodelling.
One-hundred seventy-six patients (55%) out of the 316 patients had a ≥15% reduction of baseline LVESV at 6-month follow-up. The proportion of patients with reverse remodelling varied according to different LBBB definitions and QRS duration (Supplemental Figure 1). Among all considered LBBB definitions, the ESC definitions showed the strongest association with reverse remodelling. When adjusted for confounding factors (age, gender, renal impairment, anti-remodelling therapy), the association with reverse remodelling was significant only for ESC 2009 and ESC 2013 definitions (OR 8.8, 95%CI 1.3-56.5, p 0.01 and OR 8.7, 95%CI 1.4-56.4, p 0.01, respectively).
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